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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 430710174
Report Date: 06/03/2026
Date Signed: 06/03/2026 03:27:36 PM

Document Has Been Signed on 06/03/2026 03:27 PM - It Cannot Be Edited

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SAN JOSE CC RO, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131
FACILITY NAME:DE ANZA COLLEGE CHILD DEVELOPMENT CENTERFACILITY NUMBER:
430710174
ADMINISTRATOR/
DIRECTOR:		TIM HARPERFACILITY TYPE:
850
ADDRESS:21250 STEVENS CREEK BLVD.TELEPHONE:
(408) 864-5795
CITY:CUPERTINOSTATE: CAZIP CODE:
95014
CAPACITY: 217TOTAL ENROLLED CHILDREN: 98CENSUS: 72DATE:
06/03/2026
TYPE OF VISIT:Annual/RequiredUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
08:56 AM
MET WITH:Tim Harper TIME VISIT/
INSPECTION COMPLETED:
03:35 PM
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On June 3, 2026, Licensing Program Analyst (LPA), Marilou Monico, and Licensing Program Manager (LPM), Adam Hamer, conducted an unannounced Annual Required Inspection for the preschool license with toddler option component.

LPA met with Site Director, Tim Harper, and explained the purpose of the inspection. A tour of the facility was conducted, including both indoor and outdoor areas and a census was taken. Days and hours of operation are Monday to Friday from 8:00 AM to 5:30 PM.

Disinfectants, cleaning solutions, medication and other hazardous items are made inaccessible. LPA and LPM observed that two children present in Room 26 had not been signed in by their parents, and one child was signed in on the attendance sheet for a different classroom. The Site Director was advised to ensure that all children are signed in upon arrival and that attendance records accurately reflect the classroom in which each child is present at all times.

There is no swimming pool or other bodies of water on the premises. There are no firearms or ammunition allowed or stored on the premises.

All toilets and handwashing fixtures are in safe and sanitary operating condition. Facility does not have a functioning carbon monoxide detectors. Floors in the facility are clean and safe. Solid waste storage containers have tight-fitting covers and are in good repair.

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NAME OF LICENSING PROGRAM MANAGER: Gladys Kuizon
NAME OF LICENSING PROGRAM ANALYST: Marilou Monico
LICENSING PROGRAM ANALYST SIGNATURE: DATE: 06/03/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 06/03/2026
This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)
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California Health & Human Services Agency
California Department of Social Services

FACILITY EVALUATION REPORT California law requires a public report of each licensing visit/inspection. This report is a record for the facility and the licensing agency. This report is available for public review; therefore, care is taken not to disclose personal or confidential information. Inquiries concerning the location, maintenance, and contents of these reports may be directed to the Licensing Program Analyst or Regional Office whose address and telephone number are listed on the front of this form.

DEFICIENCIES A deficiency is an instance of noncompliance with licensing requirements, including applicable statutes, regulations, interim licensing standards, operating standards, and written directives. Applicants/ licensees must be notified in writing of all licensing deficiencies. Deficiencies are listed on the left side of this form, and the applicable licensing requirement upon which the deficiency is identified. There are two types of deficiencies:
  • Type A deficiencies are violations of licensing requirements that, if not corrected, have a direct and immediate risk to the health, safety, or personal rights of persons in care.
  • Type B deficiencies are violations of licensing requirements that, without correction, could become a risk to the health, safety, or personal rights of persons in care, a recordkeeping violation that could impact the care of said persons and/or protection of their resources, or a violation that could impact those services required to meet the needs of persons in care.

PLANS OF CORRECTION (POCs) The licensing agency is required to establish a reasonable length of time to correct a deficiency. In order to set the time, the licensing agency must take into consideration the seriousness of the violation, the number of persons in care involved, and the availability of equipment and personnel necessary to correct the violation. Applicants/licensees are requested to provide a specific plan for each violation on the right side of the form across from each deficiency. The more specific the plan, the less chance exists for any misunderstanding in setting time limits and reviewing corrections. The applicant/licensee who encounters problems beyond their control in completing the corrections within the specified time frame may request and may be granted an extension of the correction due date by the licensing agency.

CORRECTION NOTIFICATION The applicant/licensee is responsible for completing all corrections and promptly notifying the licensing agency of corrections. Applicants/licensees are advised to keep a dated copy of any correspondence sent to the licensing agency concerning corrections, or if corrections are telephoned to the licensing agency, the date, person contacted, and information given.

CIVIL PENALTIES The licensing agency is required by law to issue a Penalty Notice, when applicable, to all facilities holding a license issued by the licensing agency, or subject to licensure, except Certified Family Homes, Resource Families, and Foster Family Homes, or any governmental entity.

PENALTY NOTICE GIVEN The statement concerning civil penalties serves as a penalty notice on this Licensing Report and failure to correct cited licensing deficiencies will result in civil penalties. Applicants/ licensees are required to pay civil penalties when administrative appeals have been exhausted and in accordance with any payment arrangements made with the licensing agency.

APPEAL RIGHTS The applicant/licensee has a right without prejudice to discuss any disagreement in this report with the licensing agency concerning the proper application of licensing requirements. The applicant/ licensee may request a formal review by the licensing agency to amend or dismiss the notice of deficiency and/ or civil penalty. Requests for review shall be made in writing within 15 business days of receipt of a deficiency notification or civil penalty assessment. Licensing deficiencies may be appealed pursuant to the procedures in the LIC 9058 Applicant/Licensee Rights.

AGENCY REVIEW The licensing agency review of an appeal may be conducted based upon information provided in writing by the applicant/licensee. The applicant/licensee may request an office meeting to provide additional information. The applicant/licensee will be notified in writing of the results of the agency review within 60 business days of the date when all necessary information has been provided to the licensing agency.

EMAIL REQUIREMENT Adult Community Care Facilities, Residential Care Facilities for the Chronically Ill, and Residential Care Facilities for the Elderly are required to provide and maintain an active email address of record with the licensing agency.

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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SAN JOSE CC RO, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131
FACILITY NAME: DE ANZA COLLEGE CHILD DEVELOPMENT CENTER
FACILITY NUMBER: 430710174
VISIT DATE: 06/03/2026
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Furniture and equipment are in good condition, free of sharp, loose or pointed parts. Playground equipment is in safe condition. LPA and LPM observed exposed liner fabric in the sand/tanbark box on the playground. The Site Director was advised to add additional sand or tanbark to fully cover the liner and submit photos documenting the correction to Licensing. Areas around high climbing equipment, swings and slides have cushioning material to absorb falls. LPA and LPM observed weeds present in one of the preschool playgrounds. The Site Director stated that the playground is used infrequently. The Director was advised to ensure the area is well maintained and submit photos to Licensing. LPA and LPM observed a child alone in one side of the play structure while a teacher was supervising other children on the opposite side. The remaining staff and children were located in other areas of the playground. The Site Director was immediately informed who instructed staff to ensure that all children receive adequate supervision at all times and remain within sight while on the playground.

Drinking water is available both indoors and outdoors. Drinking water is provided by personal water bottles, drinking fountains, pitchers, and disposable cups. This facility does provide meals and snacks to children. Food is delivered to the center from an outside vendor, Chefables. Menus are posted at least one week in advance where an authorized representative can view them.

Capacity and limitations as specified on the license are being maintained. At least one person trained in CPR and Pediatric First Aid is present when children are at the facility or at off-site activities. The name of the child care center director or fully-qualified teacher(s) designated to act in the director’s absence has been reported to the Department. All children are under supervision, including visual supervision, of a teacher at all times. Facility meets teacher-child ratios. LPA reviewed a sample of children’s files. There is one child (C1) enrolled in the toddler option program under two years old. The child's file include Infant Needs and Services, however LPA and LPM observed that staff only record the nap start time and end time for C1. LPA reviewed a sample of staff files and observed files were complete with health screening, immunization records for influenza, pertussis and measles and current documentation of completed mandated reporter training. Staff providing care to children who are in the toddler option program meet the education requirements.

LPA discussed the Community Care Licensing website www.ccld.ca.gov which will provide access to resources such as forms, regulations Provider Information Notices (PINs), and Quarterly Updates.

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NAME OF LICENSING PROGRAM MANAGER: Gladys Kuizon
NAME OF LICENSING PROGRAM ANALYST: Marilou Monico
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 06/03/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/03/2026
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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SAN JOSE CC RO, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131
FACILITY NAME: DE ANZA COLLEGE CHILD DEVELOPMENT CENTER
FACILITY NUMBER: 430710174
VISIT DATE: 06/03/2026
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LPA discussed Reporting Requirements as outlined in the regulations (Section 101212) and the availability of resources provided by the Technical Support Program.

Fingerprint clearances for individuals at this facility who require caregiver background checks are issued by the State Department of Education and/or the County Office of Education.



Assembly Bill (AB) 2370, Chapter 676, Statutes of 2018, requires all licensed Child Care Centers (CCCs) constructed before January 1, 2010, to test their water (used for drinking and food preparation) for lead contamination before January 1, 2023, and then every 5-years after the date of the first test. For child care center licenses issued after July 1, 2022, the licensee shall test their water for lead within 180 days of licensure pursuant to Written Directives section 101700 (PIN 21-21.1- CCP). LPA verified that the lead testing was completed in accordance with the Written Directives outlined in PIN 21-21.1-CCP.

CCC completed testing and there were no lead exceedances .



LPA discussed safe sleep regulations with Site Director and discussed the Child Care Licensing Safe Sleep webpage at https://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-andresources/safe-sleep as an additional resource. LPA also informed Site Director of the importance of checking for recalled infant devices on the United States Consumer Product Safety Commission (CPSC) website at https://www.cpsc.gov/ and recommended they register all infant devices with the CPSC to be notified of any recalls on their purchased equipment.

This facility provides Incidental Medical Services – IMS. LPA reviewed storage of medication and equipment/supplies, and reviewed children’s, personnel, and administrative records. For IMS information see PIN 22-02-CCP. The following information regarding ADA was provided: US Department of Justice (USDOJ) toll-free ADA Information Line at (800) 514-0301 (voice) or (800) 514-0383 (TTY) and link to publication. Commonly Asked Questions about Child Care Centers and the ADA are available at: https://www.ada.gov/resources/child-carecenters/.

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NAME OF LICENSING PROGRAM MANAGER: Gladys Kuizon
NAME OF LICENSING PROGRAM ANALYST: Marilou Monico
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 06/03/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/03/2026
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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SAN JOSE CC RO, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131
FACILITY NAME: DE ANZA COLLEGE CHILD DEVELOPMENT CENTER
FACILITY NUMBER: 430710174
VISIT DATE: 06/03/2026
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Site Director was informed of the MyChildCarePlan.org website; a consumer education website that helps families obtain child care by connecting them to child care providers and Resource and Referral Agencies (R&Rs) throughout California.

To improve the quality and value of the new inspection process, a survey may be sent to the email address provided. Please complete the survey and share your inspection experience. If you have any questions regarding the process or CARE tools, please send email inquiries to inspectionprocess@dss.ca.gov. For additional information regarding the inspection and its tools and methods, please visit the Program website at www.cdss.ca.gov/inforesources/community-care-licensing/inspection-process.

Exit interview conducted and report was reviewed with Site Director, Tim Harper. Appeal rights were provided.

Per Title 22, Division 12, of the California Code of Regulations, Type B deficiency is cited on the following page.

This report shall be made available to the public upon request. LIC 9213 Notice of Site Visit is provided and required to be posted for 30 days.

NAME OF LICENSING PROGRAM MANAGER: Gladys Kuizon
NAME OF LICENSING PROGRAM ANALYST: Marilou Monico
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 06/03/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/03/2026
LIC809 (FAS) - (06/04)
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Document Has Been Signed on 06/03/2026 03:27 PM - It Cannot Be Edited


Created By: Marilou Monico On 06/03/2026 at 03:01 PM
Link to Parent Document Below:
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131

FACILITY NAME: DE ANZA COLLEGE CHILD DEVELOPMENT CENTER
FACILITY NUMBER: 430710174

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 06/03/2026

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
HSC
1596.954
Every licensed child day care center shall have one or more carbon monoxide detectors in the facility that meet the standards established in Chapter 8 (commencing with Section 13260) of Part 2 of Division 12. The department shall account for the presence of these detectors during inspections.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on observation, the licensee did not comply with the section cited above which poses a potential health, safety or personal rights risk to persons in care. LPA and LPM observed that the facility does not have a functioning carbon monoxide detector.
POC Due Date: 06/05/2026
Plan of Correction
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Site Director stated that he will submit proof of a carbon monoxide detector and a written statement to confirm that the carbon monoxide has been installed at the facility by 06/05/26.
Section Cited
Deficient Practice Statement
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POC Due Date:
Plan of Correction
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Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
Gladys Kuizon
NAME OF LICENSING PROGRAM MANAGER:
Marilou Monico
NAME OF LICENSING PROGRAM ANALYST:
LICENSING PROGRAM ANALYST SIGNATURE:
DATE: 06/03/2026
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 06/03/2026


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